Dangers to Healthy Heart Function in Elderly COPD Patients

Early stage chronic obstructive pulmonary disease (COPD) may have an impact on left ventricular (LV) diastolic function, while severe COPD may affect right ventricular function, according to research published in Clinical Interventions on Aging.

Researchers from the Beijing Friendship Hospital in China observed 148 consecutive hospitalized elderly patients aged 65 years or older between December 2011 and December 2013 in order to evaluate the impact of COPD on LV diastolic function in this patient population. There were 111 men and the average age of the patients was 80 years.

There were 73 patients without COPD and 75 patients with COPD included in the study. The researchers defined mild to moderate COPD as stages 1 and 2, while severe and very severe COPD was categorized as stages 3 and 4, respectively, in accordance with the Global Initiative for Chronic Obstructive Lung Disease (GOLD) guidelines.

In total, 49 patients were categorized in GOLD stages 1 and 2 and there were 26 patients in GOLD categories 3 and 4. The researchers obtained a medical history from each patient in addition to demographics data. Comorbidities commonly included cardiovascular disease (CVD), hypertension, diabetes mellitus, cerebrovascular diseases, and chronic kidney diseases (CKD).

Levels of N terminal pro B type natriuretic peptide (NT proBNP) were higher in patients with COPD, but levels of triglycerides, serum albumin, and high density lipoprotein cholesterol were all lower in the COPD group.

In the control group, 28 patients suffered from left ventricular diastolic dysfunction (LVDD) and 19 from symptomatic heart failure. In the COPD patient group, LVDD and symptomatic heart failure were present in 48 and 38 patients, respectively.

Patients in groups 3 and 4 had significantly higher levels of NT proBNP and had a tendency toward higher frequencies of abnormal right ventricular diastolic diameter and systolic pulmonary artery pressure. There was no difference in LV diastolic function parameters between patients in the different COPD GOLD stages.

“The main finding of the present study was that there was a high frequency of LVDD in elderly patients with COPD, and that LVDD may occur in the early stages of COPD,” the authors wrote, and continued that they “observed a high frequency of LVDD in patients with COPD (65.6 percent), but there was no difference among different stages of COPD.”

The researchers further commented that this study supports the well-known link between COPD and heart failure; however, to fully quantify the risk factors for COPD and LVDD, further research must be conducted.